ISSN:1660-8151    

DOI:10.1159/000182323

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

An epidemic of HBsAg positive hepatitis involving the dialysis unit of the Seattle Veterans Administration Medical Center is described. 6 patients and 4 staff members were affected: there were four patient deaths. The source of HBsAg was identified as a chronic in-center peritoneal dialysis patient in whom both serum and peritoneal fluid were persistently HBsAg positive. Surveillance data documented heavy population exposure to HBsAg at the time of this patient’s presence in the dialysis setting. We have subsequently identified 2 other patients with HBsAg positive peritoneal effluent. Peritoneal dialysis of HBsAg positive individuals represents a significant risk for the transmission of HBsAg and clinical hepatiti

ISSN:1660-8151    

DOI:10.1159/000182324

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

Plasma renin activity and the urinary excretions of kallikrein, kinin, immunoreactive PGE (iPGE) and aldosterone were determined in 23 patients with progressive systemic sclerosis (PSS) on a fixed sodium and potassium intake who had no clinically apparent renal disease. Urinary excretions of kallikrein and kinin in the PSS patients were not significantly different from those of a group of sex and race-matched normal controls. In the female PSS patients urinary excretion of iPGE was also found to be normal. Upright PRA was appropriate for the urinary sodium excretion in 18 PSS patients (13 normotensive and 5 hypertensives) but was significantly elevated in the remaining 5 (all normotensive). The data suggest that the renal kallikrein-kinin and prostaglandin systems are unaltered in PSS patients without clinical evidence of renal disease.

ISSN:1660-8151    

DOI:10.1159/000182325

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

Urinary tract infection from Haemophilus parainfluenzae has not previously been reported. A case is reported where a 53-year-old woman had a progressive renal failure associated with infection by this organism. The bacterium might not have been detected if clinical guidance had not aided the selection of a suitable culture medium.

ISSN:1660-8151    

DOI:10.1159/000182326

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

Neoplasia developed in 14 of the first 193 patients to receive renal transplants at the Johannesburg Hospital. No case of reticulum cell sarcoma was diagnosed and an extremely high incidence of squamous carcinoma of the skin occurred. Of the latter patients, 62.5% originally suffered from analgesic nephropathy, suggesting a possible relationship between the two conditions. Transplant recipients who later developed tumours were less likely to experience rejection episodes than other recipients, and this may suggest a generally depressed immune surveillance system in these particular patients.

ISSN:1660-8151    

DOI:10.1159/000182327

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

Exchanges were performed in 1-hour and 3- to 5-hour cycles when patients were noninfected and during episodes of peritonitis. The hourly exchange dialysate effluent volume decreased with the occurrence of peritonitis. These exchanges were associated with increased glucose absorption from dialysate, diminished sodium removal and augmented clearances of urea and creatinine. Protein losses were increased in the dialysate effluent of patients during an episode of peritonitis during the hourly exchanges. In the long-dwell exchanges obtained after clinical improvement of peritonitis, only protein losses were increased over control. Clearances, sodium loss in dialysate and glucose absorption were not altered from control.

ISSN:1660-8151    

DOI:10.1159/000182328

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

The role of the renin-angiotensin system in the control of aldosterone and other mineralocorticoids was studied in 9 hyperkalemic patients with chronic renal failure showing mild azotemia (group I) and 6 normokalemic patients with chronic renal failure showing creatinine clearance similar to that in group I (group II). In group I, the plasma renin activity (PRA) was significantly low and plasma aldosterone (PAC) and 18-hydroxycortisterone (18-OH-B) were also significantly reduced. In group II, PRA was normal or slightly increased, and PAC and 18-OH-B were also normal or slightly increased. Both the PAC and 18-OH-B in group I were stimulated by ACTH and angiotensin II, although the responses were less than those in group II. In 2 patients of group I where PRA moved into the normal range after administration of furosemide, the plasma 18-OH-B and PAC also reached the lower limit of normal. These results suggest that suppression of the renin-angiotensin system is probably related to functional disturbance in the conversion from B to 18-OH-B and/or 18-OH-B to aldosterone in most abnormally hyperkalemic patients with chronic renal failure.

ISSN:1660-8151    

DOI:10.1159/000182329

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

Platelet aggregation and thromboxane B2 production, in response to adenosine diphosphate, were significantly impaired in 7 undialyzed or inadequately dialyzed patients with renal failure when compared to adequately dialyzed individuals or normal subjects. In 1 patient, platelet aggregation and thromboxane synthesis were corrected after adequate hemodialysis. The defect in both platelet aggregation and thromboxane production was induced in normal platelets incubated with uremic platelet-poor plasma. These findings suggest that the uremic platelet defect may be due, in part, to a plasma factor that inhibits platelet thromboxane synthesis. Further, adequate dialytic therapy may reverse this defect.

ISSN:1660-8151    

DOI:10.1159/000182330

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

Sickle cell nephropathy is characterized by severe defects in renal medullary functions. In contrast, both proximal tubular secretion and reabsorption are found to be elevated. Since proximal tubular cells are involved in reabsorption and catabolism of β2-microglobulin (β2-m), we studied serum concentration and urinary excretion of this low molecular weight protein in sickle cell nephropathy. Serum β2-m concentration was higher in sickle cell anaemia (SCA) patients compared to control persons. β2-m excretion, however, was normal and β2-m clearance was not significantly decreased. Fractional β2-m excretion was significantly lower and therefore tubular reabsorption of β2-m was increased in the SCA patients. There was no correlation between serum β2-m concentration and the tubular reabsorption of β2-m but there was a positive correlation both between β2-m and phosphate clearances and between fractional excretions of β2-m and phosphate. These findings are further evidence of a particular function of the proximal tubule in sickle cell n

ISSN:1660-8151    

DOI:10.1159/000182331

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

Graft membranous nephropathy (MN) appears mainly de novo or, less frequently, develops in patients whose original disease was MN. The rarity of the latter occurrence contrasts with the frequency of MN as the original disease: the existence of real recurrence may thus be questionned. We report a patient with terminal renal failure due to focal glomerulosclerosis; typical MN developed de novo in the first and recurred in the third graft. This observation establishes that recurrence of MN is a real phenomenon and demonstrates that the factor(s) determining recurrence may appear only after transplantation. Neither HBS nor antilymphocyte serum antigens were found along the basement membrane. The late onset of proteinuria after the third graft demonstrates that the delayed appearance of clinical signs of glomerular disease does not rule out the recurrence of MN.

ISSN:1660-8151    

DOI:10.1159/000182334

出版商:S. Karger AG    

年代:1981

数据来源: Karger